Oncologist
She expanded her concern for child cancer patients to include their families, which led to creating Ronald McDonald Houses to care for families of sick children.
FAMILY BACKGROUND
Audrey Evans (AE) was born in York, England. Her father worked in paper products manufacturing. Her mother was a homemaker.
CHILDHOOD
“I always knew I wanted to be a doctor,” said AE during a 2017 episode of “Modern Hero,” a documentary series about extraordinary women. “Fortunately, my parents believed that girls should do as well as boys, so off I set.”
EDUCATION
AE graduated from the Royal College of Surgeons in Edinburgh, Scotland. A Fulbright fellowship brought her to Boston Children’s Hospital, where she studied with Dr. Sidney Farber, the noted cancer researcher, among others. A drawing on his wall showing a circle of caregivers with the family at the center first got her thinking about how illness affected more than just the patient.
“A family with a sick child is a sick family,” said AE. “So, you must think about everybody – the siblings, the mother, the father, maybe also the grandmother. You must remember that they’re all part of a group.”
ONCOLOGY DEFINED
Oncologists are doctors who diagnose and treat cancer. They often act as the main healthcare provider for someone with cancer – designing treatment plans, offering supportive care and sometimes coordinating treatment with other specialists.
Oncology is the study of cancer. Oncologists:
- Confirm (or not) a patient’s initial diagnosis
- Explain the cancer diagnosis and stage (progression)
- Provide all possible treatment plans with recommendations
- Oversee the course of treatment
- Help patients manage symptoms and side effects of both the disease and the treatment plan
Typically, oncologists have a specialty within the field so they often expand a patient’s team to include the appropriate doctors for the chosen treatment plan.
Hematology oncologists are board-certified to deal with blood conditions such as anemia (from shortage of red blood cells), sickle cell disease (an inherited disorder affecting circulation) and thrombosis (involving blood clots blocking blood vessels.)
Surgical and radiation oncologists assist in diagnosis and treatment when surgery or radiation therapy is needed.
Other oncology specialists focus on treating cancer in specific areas of the body. For example, gynecologic oncologists treat uterine, ovarian and cervical cancers. Pediatric oncologists specialist in cancers common in children and teenagers.
Training and education involve graduation from medical school, advancing to a two to five year residency program, obtaining a medical license and passing required board certification exams, completing graduate or fellowship programs in a chosen oncology specialty and passing subsequent licensing exams.
FIRST JOBS ARE NEVER A BINDING CAREER COMMITMENT
After working as an oncologist in Boston, then moving to Chicago, AE was offered a job as Chief of Pediatric Oncology at Children’s Hospital in Philadelphia (CHOP).
Dr. Evans, who chose to focus on pediatric oncology, became a renowned figure in the world of childhood cancer. In 1971 she developed what has become known as the Evans Staging System, a protocol for assessing patients with neuroblastoma, a childhood cancer that involves nerve cells. The system helps determine which children need aggressive treatments and which could be aided with less invasive methods.
As Chief of oncology at CHOP, EA became known for doing things a little differently. Once, for instance, she realized a young patient might be less resistant to powerful chemotherapy treatment if she were allowed to bring her pet rabbit into the unit. Another child brought a parakeet.
“Fortunately, nobody liked oncology,” recalled Dr. Evans. “The people who ran the place would rather not go to the oncology floor. So, I got away with things I could do in oncology, which I’m sure you couldn’t have done on a more healthy ward.”
EA led the oncology unit for 20 years. When she first arrived, feeling the call to care for children, “there wasn’t much else you could do but care,” because the mortality rate for young cancer patients was high. She thought she could at least help them through what was ahead. “I knew a lot of them were going to die, and I could talk about dying.”
But during her tenure the child cancer mortality rate dropped – by 50 percent for neuroblastoma patients, according to many accounts.
EXPANDING CARE TO THE SICK CHILD’S FAMILY
While Chief of pediatric oncology at a world-famous children’s hospital, EA had been pondering how to help families who brought their children from afar for care when she connected with an unlikely ally, the Philadelphia Eagles of the National Football League (NFL) – unlikely because Dr. Evans, born in England, had no idea what the Eagles or American football were.
By fortunate or unfortunate coincidence (it may be viewed as a combination of both), an Eagles football player, Fred Hill, had begun raising money for leukemia research when he found out that his daughter Kim had the disease. Teammates and the team’s owner at the time, Leonard Tose, got involved, and after a particularly successful fund-raiser, the team went looking for a local cause that would be visible to the people who had donated, rather than just giving the money to a national leukemia organization.
Jim Murray, then Mr. Tose’s right-hand-man (fixer), later the team’s General Manager, recalled that another physician referred him to Dr. Evans. When Murray introduced himself, he later recalled in a phone interview, he had to explain that the Eagles were the local pro football – not like British soccer – team.
That didn’t mean much to Dr. Evans since she was unfamiliar with the sport, but Mr. Murray got her full attention when he told her he had some money to put into a charitable cause. She immediately thought of the families of her patients, who would sometimes sleep in their cars or hospital hallways when they brought their children in for treatment. She said she’d love to provide a house where these families could stay.
Mr. Murray next approached an adman, Don Tuckerman, who handled the account for Philadelphia-area McDonalds’ restaurants, which were promoting Shamrock Shakes at the time, and asked if the franchises might donate 25 cents to the cause for each one sold. Instead, McDonald’s offered ALL the proceeds from that promotion, with the proviso that the Philadelphia house be named after the company’s familiar clown character. Eventually, McDonalds expanded the reach of this program across the full regions served by McDonalds’ franchises.
The original Ronald McDonald House opened on Spruce Street in Philadelphia in 1974. As of late 2022, there were 380 houses across the United States and other countries, providing not merely a cheap bed but also home-cooked meals and emotional support as ‘veteran’ families mingled with newcomers.
CAREER SATISFACTION
Dr. Evans, an Episcopalian, often spoke of feeling called by God to care for children. Mr. Murray also saw a higher hand in their unlikely pairing. “I couldn’t cut open a frog,” he said. “I couldn’t even pass biology and here I was talking to all these doctors. She didn’t know what the Eagles were, but God put us together.”
A medical colleague noted that Dr. Evans knew she would be celebrated for her many achievements. However, Dr. Evans would often say that “caring was the most important thing she did.”
A childhood friend of Dr. Evans recalled that when the two of them would go on walks, Dr. Evans would literally stop and smell the roses, cuddle strangers’ babies, hand out dog treats (which she always carried in her purse despite not having a dog) and she’d start a conversation with anyone who seemed like they were having a bad day. If you asked her why, she would say, “We just made that person’s day a little better – that wasn’t so hard now, was it?”
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This career story was based on multiple sources, including an article written by Nell Genzlinger, published by The New York Times on 9/30/2022 plus internet research.
